Data presented at a five-day stakeholder meeting shows ‘significant success in screening and treatment for tuberculosis in Free State, Northern Cape and KwaZulu-Natal prisons.
Inmates and people who work at the Department of Correctional Services (DCS) are at high risk of contracting TB which in turn can filter back into their communities. To address this serious issue, there is a large national TB programme underway which helps to address TB risks in the prison system where inmates and DCS workers face overcrowded conditions and where the prison design of many facilities can exacerbate the problem, which is showing significant success.
TB screening of inmates has increased to more than 90% on admission with almost 180,000 screened on admission for TB since the programme began in 2014. Almost 32,000 people were screened for TB using chest x-rays in this financial year after exceeding previous targets.
This was revealed at a five day TB and HIV/Aids meeting which is currently underway with representation from DCS in three provinces, the National Department of Health, Global Fund, Right to Care and other partners.
Some highlights include that based on preliminary data available from the Free State/Northern Cape and Kwa-Zulu Natal regions, 82% of inmates on antiretroviral therapy (ART) are virally suppressed. In line with the National Development Plan 2030, the UN Sustainable Development Goals and UNAIDS 90-90-90 targets of 2020, Universal Test and Treat (UTT) was also implemented from 1 September 2016 within correctional centres. This strategy aims at ensuring clients testing HIV positive are initiated immediately on ART regardless of CD4 count, increasing health outcomes and reducing the transmission of HIV. Waiting lists for ART initiation has also been reduced due to 105 nurses who have been specifically trained to initiate antiretroviral treatment.
In nine months, all supported centres have transitioned onto the National Department of Health electronic patient database. Infection prevention and control activities and support is being implemented across supported facilities by committees and pharmacy therapeutic committees have been established. There has been an increase in peer educators who are fellow inmates and officials being trained on adherence and support groups have also help to improve inmate access to care and treatment adherence.
Right to Care supports 81 correctional centres in 13 management areas in two of six regions; KwaZulu-Natal, Free State/Northern Cape.
Targets achieved by Right to Care include: HIV counselling and testing (HCT) = 133 654 (July 2014 – Jan 2017); comprehensive prevention package = 9785 (Nov 2016 – Jan 2017); TB screened = 430 106 (July 2014 – Jan 2017); initiated on antiretroviral treatment on UTT = 2 445 (Sept 2016 – Jan 2017); initiated on TB treatment = 1239 (July 2014 – Jan 2017); trained on TB/HIV = 2644 (April 2016 – Jan 2017); and on the Department of Health’s electronic patient database phase 3 & 4 = 79 facilities (March 2016 – Jan 2017)
The impetus for this programme is to align with the WHO guidelines and the UN’s Sustainable Development Goal 3 which ensures healthy lives and promotes well-being for all and to end the epidemics of Aids, tuberculosis and other communicable diseases by 2030. It also addresses the UNAIDS Fast-Track strategy to end Aids by 2030 and the 90-90-90 targets for 2020. DCS continues to work towards achieving these targets.